Relationship between traditional Chinese medicine constitutional types with chemotherapy-induced nausea and vomiting in patients with breast cancer: an observational study

Wumei pills attenuates 5-fluorouracil-induced intestinal mucositis through Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB pathway and microbiota regulation

BACKGROUND

Radiotherapy and chemotherapy can kill tumor cells and improve the survival rate of cancer patients. However, they can also damage normal cells and cause serious intestinal toxicity, leading to gastrointestinal mucositis[1]. Traditional Chinese medicine is effective in improving the side effects of chemotherapy. Wumei pills (WMP) was originally documented in the Treatise on Exogenous Febrile Diseases. It has a significant effect on chronic diarrhea and other gastrointestinal diseases, but it is not clear whether it affects chemotherapy-induced intestinal mucositis (CIM).

AIM

To explore the potential mechanism of WMP in the treatment of CIM through experimental research.

METHODS

We used an intraperitoneal injection of 5-fluorouracil (5-Fu) to establish a CIM mouse model and an oral gavage of WMP decoction (11325 and 22650 mg/kg) to evaluate the efficacy of WMP in CIM. We evaluated the effect of WMP on CIM by observing the general conditions of the mice (body weight, food intake, spleen weight, diarrhea score, and hematoxylin and eosin stained tissues). The expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, and myeloperoxidase (MPO), as well as the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB (TLR4/MyD88/NF-κB) signaling pathway proteins and tight junction proteins (zonula occludens-1, claudin-1, E-cadherin, and mucin-2) was determined. Furthermore, intestinal permeability, intestinal flora, and the levels of short-chain fatty acids (SCFA) were also assessed.

RESULTS

WMP effectively improved the body weight, spleen weight, food intake, diarrhea score, and inflammatory status of the mice with intestinal mucositis, which preliminarily confirmed the efficacy of WMP in CIM. Further experiments showed that in addition to reducing the levels of TNF-α, IL-1β, IL-6, and MPO and inhibiting the expression of the TLR4/MyD88/NF-κB pathway proteins, WMP also repaired the integrity of the mucosal barrier of mice, regulated the intestinal flora, and increased the levels of SCFA (such as butyric acid).

CONCLUSION

WMP can play a therapeutic role in CIM by alleviating inflammation, restoring the mucosal barrier, and regulating gut microbiota.

Traditional Chinese Medicine Therapy for Esophageal Cancer: A Literature Review

Esophageal cancer (EC) is the sixth leading cause of cancer-related deaths worldwide. Western medicine has played a leading role in its treatment, but its prognosis remains unsatisfactory. Therefore, the development of effective therapies is important. Traditional Chinese medicine (TCM) has been practiced for thousands of years, and involves taking measures before diseases occur, deteriorate, and recur. Interestingly, there is growing evidence that TCM can improve the therapeutic effects in reversing precancerous lesions, inhibiting the recurrence and metastasis of EC. In this article, we review traditional Chinese herbs and formulas that have preventive and therapeutic effects on EC, summarize the application and research status of TCM in patients with EC, and discuss its shortcomings and prospects in the context of translational, evidence-based, and precision medicine.

A systematic review and meta-analysis of traditional Chinese medicine with chemotherapy in breast cancer

Background

With the continuous progression of a new generation of adjuvant chemotherapy, the survival time of breast cancer patients has also been significantly improved. Chemotherapy alone will cause a series of side effects, which will seriously affect the quality of life of breast cancer patients. Chinese medicine combined with neoadjuvant chemotherapy has a unique advantage in the treatment of breast cancer.

Methods

English databases were searched using combinations of the following search terms: "traditional Chinese medicine", "neoadjuvant hemotherapy", "breast cancer", and "tumor of breast". Publications in which traditional Chinese medicine (TCM) combined with neoadjuvant therapy was the experimental group and chemotherapy alone was the control group were screened.

Results

A total of 12 publications were included in the meta-analysis. The efficiency of the performance status score was used to test for heterogeneity, Chi²=2.95, df=5, P=0.71>0.1, I²=0%, Z=3.36, odds ratio (OR) =2.61, and 95% confidence interval (CI), 1.49-4.58. The results of the heterogeneity test of the effective rate of the objective curative effect were as follows: Chi²=1.04, df=7, P=0.99>0.1, I²=0%<50%, Z=2.42, OR =2.00, and 95% CI, 1.14-3.49. The results for the heterogeneity test of the TCM syndrome score were as follows: I²=83%, P<0.00001, mean difference (MD) =8.84, 95% CI, 6.43-11.25, P<0.05. The results for the heterogeneity test of the incidence of adverse reactions in the digestive system after chemotherapy were as follows: Chi²=1.15, df=8, P=1.00>0.1, I²=0%<50%, Z=1.68, OR =0.04, 95% CI, -0.01 to 0.09.

Discussion

The meta-analysis confirmed that using TCM combined with neoadjuvant chemotherapy to treat breast cancer has obvious advantages over chemotherapy alone in terms of the objective curative effect, the performance status score effective rate, the TCM syndrome score change, and the incidence of gastrointestinal adverse reactions after chemotherapy.

ShenQi FuZheng injection as an adjunctive treatment to chemotherapy in breast cancer patients: a meta-analysis

Context: Shenqi FuZheng injection (SFI) has been suggested as a complementary treatment of chemotherapy in China. However, little is known about it in western countries. Objective: This study assesses the clinical effect of SFI combined with chemotherapy for breast cancer patients. Materials and methods: Both English and Chinese databases were searched covering the time period of 1999- 2018 for relevant studies comparing the effect of SFI plus chemotherapy treatment with chemotherapy alone in patients with breast cancer. Target outcomes concerning treatment effect, performance status, immune system and toxic effects were extracted and combined using Stata version 15.0 software. Quality assessment was performed using the Jadad scale. Results: Forty-nine trials were included based on certain selection criteria. Only seven studies were rated as high-quality publications. Results of meta-analysis showed that SFI intervention can significantly improve objective tumour response, performance status, NK, CD₃⁺, CD₄⁺ and CD₄⁺/CD₈⁺ ratio and reduce occurrence of leucopenia, thrombocytopenia, haemoglobin reduction, liver dysfunction, gastrointestinal reaction, nausea and vomiting, bone marrow suppression and ECG changes. However, no significant difference was found between SFI and the control group regarding CD₈⁺ levels, and renal disorders. Discussion and conclusions: SFI intervention appeared to be effective in improving clinical efficacy, immune function and reducing toxicity when combined with chemotherapy for breast cancer. However, our findings still need verification by high-quality trials.

Association study of diabetes mellitus and body constitution of traditional Chinese medicine

Objective: We report on the association between traditional Chinese medicine (TCM) constitution and diabetes mellitus (DM) and provide epidemiological evidence for the theory of correlation between constitution and disease.

Methods: A total of 3748 participants were used for data analysis, and all study subjects underwent a complete clinical baseline characteristics evaluation to collect related information. DM was determined by an oral glucose tolerance test. Multiple logistic regression (MLR) models were employed to detect the associations.

Results: In total, 16.84% of the participants had DM in the total sample. Significant differences were found in age, height, weight, and heart rate, between the DM and non-DM groups. Univariate linear regression analyses indicated that the variables Qi_Deficient and Yang_Deficient were significantly associated with the outcome, and a negative correlation between TCM constitution and DM was found. After adjustment for relevant potential confounding factors, the MLR detected significant associations between both the Qi_Deficient and Yang_Deficient variables and DM ([Formula: see text]-value [Formula: see text] 0.015 for Qi_Deficient and [Formula: see text]-value [Formula: see text] for Yang_Deficient). In Qi_Deficient and Yin_Deficient participants, the odds ratios (ORs) for DM were 0.778 and 0.646, respectively.

Conclusion: Qi_Deficient and Yang_Deficient were significantly associated with DM. These findings may provide insights for clinical practice for the prevention and diagnosis of DM.

Exploring the Pharmacological Mechanism of Danzhi Xiaoyao Powder on ER-Positive Breast Cancer by a Network Pharmacology Approach

Background

Breast cancer is the most common malignancy among women worldwide, but the long-term endocrine therapy is frequently associated with adverse side effects. Danzhi Xiaoyao powder (DXP) is a herbal formula that has an effect on breast cancer, especially ER-positive breast cancer. However, the active compounds, potential targets, and pharmacological and molecular mechanism of its action against cancer remain unclear.

Methods

A network pharmacology approach comprising drug-likeness evaluation, oral bioavailability prediction, Caco-2 permeability prediction, multiple compound target prediction, multiple known target collection, breast cancer genes collection, and network analysis has been used in this study.

Results

Four networks are set up—namely, ER-positive breast cancer network, compound-compound target network of DXP, DXP-ER-positive breast cancer network, and compound-known target-ER-positive breast cancer network. Some ER-positive breast cancer and DXP related targets, clusters, biological processes, and pathways, and several potential anticancer compounds are found.

Conclusion

This network analysis successfully predicted, illuminated, and confirmed the molecular synergy of DXP for ER-positive breast cancer, got potential anticancer active compounds, and found the potential ER-positive breast cancer associated targets, cluster, biological processes, and pathways. This work also provides clues to the researcher who explores ethnopharmacological or/and herbal medicine's or even multidrugs' various synergies.

Association between Nine Types of TCM Constitution and Five Chronic Diseases: A Correspondence Analysis Based on a Sample of 2,660 Participants

OBJECTIVE

The purpose of this study was to explore the association of nine types of Traditional Chinese Medicine (TCM) constitution with the five chronic diseases: hypertension, hyperlipidemia, diabetes mellitus, heart disease, and obesity.

METHODS

Chi-squared test was performed to investigate the distribution characteristics of TCM constitutions in the participants with the five chronic diseases in questionnaire. Correspondence analysis was used to explore the correlation between them.

RESULTS

A total of 2,660 participants (1,400 males; 1,260 females) were included in this study. The mean age was 52.54 ± 13.92. Of them, 600 were of gentleness type accounting for 22.56%. Proportions of gentleness type in the chronic diseases (16.00%~23.70%) were less than that in general population (32.14%). The gentleness type and yin-deficiency type were significantly correlated with hypertension and diabetes mellitus, qi-deficiency type was correlated with heart disease, phlegm-dampness type was associated with obesity, and dampness-heat type was correlated with hyperlipidemia.

CONCLUSIONS

The correlations between TCM constitution types and the five chronic diseases were different. This may have a significant implication for TCM practice, and even the people with gentleness type should not be ignored in health management.